love, life, and the pursuit of liberation
I realize that I use a LOT of lingo in my blog and even though I have a key to some of it on the side, it probably goes above your head. So let me break down what in the hell I’m talking about.
Because I’m a lesbian, in order for me to get pregnant, I need to use ART (artificial reproductive technology) because I choose not to have physical sex with a male. The two main types are IUI (intra-uterine insemination) and IVF (in vitro fertilization). It also involves a LOT of different medicines. Here we go.
IUI– turkey baster
This process can be done at home or with a specialized doctor (RE- reproductive endocrinologist), with or without medication. Basically, you track your menstrual cycle, wait for ovulation (which typically occurs around day 14- 14 days after your first menstrual cycle), then squirt sperm (fresh or thawed frozen sperm) through your cervix into your uterus. The sperm meets the egg that has been released and hopefully fertilizes it. The fertilized egg travels down, implants in your uterus lining and then you’re pregnant. You know you’re pregnant because embryo makes hcg which is what a pregnancy test measures. These numbers are also called a beta reading and should double about every 24 hours or so.
People who have difficulty ovulating or if they want to pinpoint the timing of ovulation use medications (clomid, gonadotropins, etc) that stimulate ovaries to grow. Most of these medications are self-administered injections. Then they trigger ovulation with a self-injection of hcg that causes the follicles to mature and ovulate. Women go to the RE every couple of days to measure the size of the follicles (they are ready to trigger when they are about 17mm) and to get their estrogen levels tested (which also indicate egg readiness).
I tried this 12 times. Obviously, it didn’t work for me. Now onto IVF
IVF- test tube babies
This process is similar to IUI only in that it utilizes a lot of medicine to control reproduction artificially. There are some huge differences, however.
First, most people suppress or shut down their normal reproductive functioning prior to stimulation with self-injectables. Basically, you medically induce menopause so that when you start the stimulation medications, your body is responding only to the medication and not any natural hormones that your body secretes. This is for control. Your body goes back to functioning normally when this medication stops. I’m using lupron for this. Some women are also prescribed birth control.
Around day 3 of your next cycle, you start the stimulating medications like IUI but in bigger doses. I’m using gonal-f and repronex. The goal is to produce multiple follicles. About 1/3 of follicles won’t make it to insemination, another third won’t fertilize, and then if you transfer only 1-2, the rest will be frozen (and not all of those frozen embryos will make it either). This is why you need so many follicles to start off with.
Again, like IUI you are monitored, but more frequently. I’m onto daily monitoring now. Also, like IUI you inject a trigger of hcg, but the timing is absolutely crucial because you have to be on the operating table when you ovulate. Too soon, you just lost all those eggs.
34 hours after triggering ovulation, you go under general anesthesia, have a needle inserted through your vaginal walls, and have all the follicles sucked out. This is called the retrieval. The specialists then harvest the eggs out of those follicles, fertilize them, let them grow for 3 or 5 days and then transfer them back into your uterus, much like IUI. This is called the transfer. Hopefully, the embryos implant and you are pregnant.
There are two main ways that fertilization can happen. Either “naturally” with the sperm swimming in a dish with the egg or through ICSI where a single sperm is injected into each egg. Additionally, there are a variety of reasons why someone would transfer a 3 day versus a 5 day embryo. You can google that because that’s a huge topic. Lastly, 3 day embryos can undergo “assisted hatching” where a microscopic hole is drilled in the shell of the embryo in order to help it “hatch” or shed it’s shell which is necessary for implantation. A lot of embryos have difficulty doing this, so assisted hatching helps.
My protocol will be- ICSI, 3-day transfer, assisted hatching.
The fun (and medications) don’t stop with the transfer. Because your whole follicle is sucked out, it’s important to use progesterone to support early pregnancy. You can get progesterone in a cream, suppository or injectable form. I’ve been prescribed the suppository and injectable form. What joy! This medication is to be used for several weeks after transfer to support early pregnancy.
So there you have it. More than you ever wanted to know about how ART works. This is a very rough, non-scientific, general version but hopefully it gives you an overview of what the hell I’m talking about in my infertility posts. Please, please, please ask any questions you have because I’m sure I’ve left something out or have been unclear about something.